Blogs

Herbal Remedies and Sedation Medications: Know the Dangers

Find out how the use of seemingly-innocuous herbal supplements might affect patient response to your procedures. What are the ingredients you need to watch out for?
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Are You Ready for the New Boom in Pediatric Dentistry?

Pediatrics is the fastest-growing market in dentistry. Dr. Roger Sanger explains how DOCS Education's updated protocols can keep you on top of the new wave.
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Resolution 77: The Most Monumental Mistake the ADA Could Ever Make

The ADA is voting on revised sedation guidelines, known as Resolution 77, on November 10. The resolution will obliterate oral sedation dentistry—and put you and your patients at risk.

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One Step Closer to an Enamel Restorative Treatment

Researchers in England report progress in the search for an effective restorative agent that can curtail infection and sensitivity. If dentinal tubules, nanoparticles and fluorosurfactants are your thing, keep reading.

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Why Anesthetics Aren't Effective for Long Cases

A member has been on a losing streak when it comes to keeping his patients numb and comfortable for restorations. Why isn't the anesthetic as effective?

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The Single Most Important Reason Why Every Dentist Needs Advanced Life Support Training

It's inarguable, infallible and undisputable. Just ask veteran dentist and longtime DOCS Education Member Dr. Steve E. Chamish.

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Millennials Prefer Dentists to the Banking Industry

A study shows that Millennials are primed to wreak havoc on the banking industry, which has nothing to do with dentistry. Or does it?

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Is it Safe to Sedate a Bipolar, Diabetic Smoker with Active Hep. C?

A patient presents with multiple medical conditions, including bipolar disorder, diabetes and an active HCV infection. To top it all off, she's a smoker. Should the clinician proceed with oral conscious sedation?

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Why Google and the Movie Industry are Fighting over Dental Aligners

A lawsuit between two dental alignment device-makers is pitting Google and Apple against the movie and recording industries. Who knew dentistry could be so divisive?

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Should I Take on this Case or Punt to OR?

Sometimes even the most experienced sedation dentists need a little help from their friends. A DOCS Education Fellow seeks advice from faculty about whether he should take on a sedation case or refer it out.

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A member of DOCS Education asks:

It seems I have an abundance of cops and nurses in the practice, and all seem to be taking some form of anti-anxiety meds or BP meds. Well, someone has to treat them and I have had great success with the DOCS protocol, but could use some suggestions here on an upcoming patient:

Patient is 5 9" / 220 lbs. He is a half-pack a day smoker. No snoring, or so he says. BP today was 148/89, HR 86'. I have seen diastolic pressure at 95 on a previous visit. Meds are as follows:


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A member of DOCS Education asks: My patient is a 21 year old female who presents for IV sedation and operative dentistry. She smokes 0.5 packs/day, reports she has bronchitis but has no medication for such. She also states she takes Depakote® for bipolar disorder and Propranolol for tachycardia. Lexicomp shows no interactions with the Depakote® and only a C rating for Fentanyl (a non-benzodiazepine) and Propranolol. No other interactions are listed.
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A Member of DOCS Education asks: The Sedation Dentistry Guidebook offers a form titled "Sedation Appointment Checklist." The checklist outlines some instructions specifically for smokers, specifically how long to refrain from smoking after a sedation appointment. To clarify, are we to use this form to communicate to patients how long they are not to smoke before their sedation appointment? I remember from the DOCS course that smokers were encouraged to smoke before and throughout the sedation appointment as needed. Do we offer this option to all patients that smoke, or only to those who smoke beyond a specific threshold of cigarettes per day? Off of that, what is the protocol for allowing a patient to smoke during the sedation appointment? Should we keep the pulse ox attatched to the patient and accompany them outside? Any clarification would be appreciated?
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A DOCS Education member brings this question to the forum: I would appreciate some input regarding this patient, a 56 year old female, 5 feet and 1.5 inches tall, 248 lbs. She is a non-smoker. I have an upcoming treatment appointment with her and I plan on using a Triazolam titration protocol with her starting with .25 mg of Triazolam one hour prior to her appointment. She reports the following medical conditions: Hypertension Diabetes Asthma Hay Fever Hypothyroidism Fibromyalgia
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A DOCS Education member asks: I have a patient that I plan on doing a RCT under sedation. Health hx normal. Allergic to Morphine and NSAID. Meds taking: estrogen, metroprolol tartrate. BP: 146/74, Pulse: 66, SPO2: 99. She said Valium didn't do much for her before, and one dentist had tried to do IV sedation on her and she was awake the whole time and "felt everything he did". My initial plan is do single Dose Protocol #3 with diazepam 5 mg night before, triazolam 0.25 mg and hydroxyzine 25 mg one hr before procedure. Is it worth the try or would another protocol be better served for this patient?
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A DOCS Education member asks: My first teen sedation patient will be coming into the office in a few days and I have a couple of questions I hope you can answer for me. The patient is a 14 year-old female weighing 106 lbs, taking no medications and has an unremarkable medical history. Her main complaint is anxiety of shots from a previous dental experience. Her treatment will consist of #18-0, #19-O and #31-O composites. I plan on using Teen Protocol 2.
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